Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

What are monoamine oxidase inhibitors (MAOIs)?

MAOIs were the first class of antidepressants to be
developed. They fell out of favor because of concerns about interactions with
certain foods and numerous drug interactions.
MAOIs elevate the levels of
norepinephrine, serotonin, and dopamine by inhibiting an enzyme called monoamine
oxidase. Monoamine oxidase breaks down norepinephrine, serotonin, and dopamine.
When monoamine oxidase is inhibited, norepinephrine, serotonin, and dopamine are
not broken down, increasing the concentration of all three neurotransmitters in
the brain. They are also used for treating Parkinson's.

What are the side effects of
MAOIs?

Since MAOIs work in the brain and affect neurotransmitters, they have
many side effects. Side effects of MAOIs are:

MAOIs are not recommended for use with medications like
pseudoephedrine, phenylephrine, ephedrine, and phenylpropanolamine. The
combination of MAO inhibitors and these drugs can cause an acute hypertensive
episode.

Monoamine oxidase also breaks down tyramine, a chemical present in aged
cheese, wines, and other aged foods. Since MAOIs inhibit monoamine oxidase, they
decrease the breakdown of tyramine from ingested food, thus increasing the level
of tyramine in the body. Excessive tyramine can elevate blood pressure and cause
a hypertensive crisis. Patients treated with MAOIs should adhere to recommended
dietary modifications that reduce the intake of tyramine.

What about taking
MAOIs during pregnancy or while breastfeeding?

The FDA classifies MAO inhibitors in pregnancy category C, which means that
there is no established evidence of safe and effective use of MAO inhibitor in
pregnant women. Therefore, infant risk cannot be ruled out. It is not known
whether MAO inhibitors enter
breast milk; however, MAO inhibitors should be
avoided in nursing mothers to avoid harm to the fetus.

Summary

Monoamine oxidase inhibitors (MAOIs, MAOI) is a class of antidepressants. They are infrequently prescribed because of concerns about interactions with particular foods and several drug interactions. Side effects, drug interactions, storage, dosage, and pregnancy safety information should be reviewed prior to taking any medication.

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